Tackle smoking under hudud?

Professor Tan Sri Dato' Dzulkifli Abdul Razak
Learning Curve: Perspective
New Sunday Times - June 7, 2016

THE World No Tobacco Day came and went on May 31 without much fanfare as though it was a non-issue in our society and community. Instead the hudud bill has been hogging the headlines with politicians and their allies posturing for potential votes with by-elections around the corner. The overall passion expressed, if misinformed, is enviable to the extent that some ministers have volunteered to resign if the outcome did not favour their party’s stand. This kind of hubris is rare and somehow does not apply when it ought to, given the plethora of issues that would have demanded so.

One is when it comes to tobacco control in relation to proliferation of hard drugs over almost five decades. And it seems to be worsening. According to the Ministry of Health, as of April last year, the number of smokers among Malaysian men has shot up to 38% while for women it was 1.4%. This was revealed at the Kuala Lumpur Nicotine Addiction Conference by Deputy Director-General of Health (Public Health) Datuk Dr Lokman Hakim Sulaiman, who expressed his deep concern over the high numbers.

“This would mean roughly 4.7 million smokers, out of nearly 30 million Malaysians,” he said. “Most start before the age of 18.” He highlighted that of individuals who began smoking as minors, 25% did so before the age of 10.

And as Lokman noted, although we have an advanced healthcare system, yet the prevalence of non-communicable diseases (NCDs), such as stroke or cancer, is “among the highest in the Asean region” implying a link between NCDs and smoking. Tobacco-related deaths in Malaysia in 2010 was 19% for men and 8.2% for women, reportedly a higher than average death rate than other middle-income countries.

In terms of absolute numbers some 20,000 Malaysians die annually from smoking; something that could have been avoided if they never smoked or had quit.

Still the political will displayed by almost all politicians has never been as “concerned” as compared to what we hear and read with respect to that of the hudud bill. At least no one has threatened to resign should the attempt to curb smoking fail as implied by the statistics. That the loss of Malaysian lives seems not high enough to prick their conscience to put their reputation on the line as worthy elected representatives.

Instead we were surprised by the announcement on the eve of No Tobacco Day that from Dec 1, 2017, the sale of alcoholic beverages will be restricted to consumers above 21 years of age from 18 now. Health Minister Datuk Seri Dr S. Subramaniam was reported saying that alcoholic beverages for sale would be displayed in cabinets or racks separate from those for other food. In addition, all the alcoholic drinks must carry the label “Drinking alcohol is injurious to health”. All these in keeping with the global strategy to reduce the harmful use of alcohol.

But what about tobacco? It boggles the mind why tobacco products are not treated the same way knowing full well that most of the 4.7 million-odd smokers in Malaysia start before they are 18; indeed 25% did so before the age of 10. Again the number of deaths due to alcoholism is nowhere near that of tobacco users.

In March last year, the US Institute of Medicine, a prestigious scientific authority, concluded that raising the legal minimum age for tobacco buyers to 21 will have a substantial positive impact on public health and save lives because it “will significantly reduce the number of adolescents and young adults who start smoking; reduce smoking-caused deaths; and immediately improve the health of adolescents, young adults and young mothers who would be deterred from smoking, as well as their children.”

Even tobacco companies recognise this. According to a Philip Morris report dated January 1986: “Raising the legal minimum age for cigarette purchaser to 21 could gut our key young adult market (17-20) where we sell about 25 billion cigarettes and enjoy a 70% market share.”

So, how did we miss such a powerful piece of evidence? Where are the politicians, especially in the related ministries? Perhaps by putting tobacco control and its use under the purview of the proposed hudud bill will wake them up from their slumber.